Discussions By Condition: Medical Stories

Back injury at work\ 30# board on top of head

Ok, I just found this site, and I have real doubts about the doctors' knowledge of the injury. I am an Ironworker, and three weeks ago a 30 pound piece of material fell off a wall and came down from 8' to 10' and hit me squarely on the top of my head. I had a hard hat on, and a welding hood that attached to my hard hat. The welding hood was split nearly in two from the blow, and it really knocked me silly for a few minutes. It didn't knock me out, but I was very dizzy and instantly had a headache. Another Ironworker standing next to me said he couldn't believe I stayed standing when it happened. My knees buckled a bit, but I stayed standing. In other words, the whole force rammed me like a pile driver. I've had a headache ever since, my whole head, with the majority at the back right from the bottom of the skull up to the top\right\rear where the block hit my hard hat and hood. I'm also sore from the small of my back (burning\stabbing\aching), to the top of my head. Neck, shoulders, shoulder blades, and spine area, with spots at the lower back, mid-lower back and shoulder blade area where the pain shoots out to the right of the spine about 3-4 inches. For a few days I also had pain in my right knee and ankle and right arm at the elbow and wrist. I've seen an orthopedic surgeon through the contactors' work comp insurance, who has prescribed physical therapy, which I've done for 5 visits. Today was my 2nd visit to the doctor, and he is sending me back to PT for two more weeks. Here's the problem. On my first visit to this doctor, he took xrays and told me immediately that I have spondylolithesis, and that it was a birth defect. He also said it was very common and lots of people are born with it. My wife and I were in the room as he went on to tell me that I have signs of arthritis in my neck vertebrae. I was puzzled that he didn't ask me more specific questions about where and what was going on, and where it hurt. He prescribed phys. therapy and Darvocet, flexeril and anti-inflamatories. When I got home, I started researching spondylolisthesis, and found it affects like 5-10%, and that people can get it from a wide variety of things, such as football, weightlifting or a trauma, such as someone jumping out of a tree and landing on their feet. (i.e., my injury in reverse). The doctor made it sound like it was an absolute that it was from birth, not from an accident. He seemed to pinpoint things on the xrays that he thought were there already, but blew over the immediate symptoms. And this was a doctor that a work comp attorney had referred me to, not a company doctor. I also started talking to other people who had had back injuries, and they were surprised that I hadn't been told to get an MRI immediately. I've been told that xrays leave a lot of room for error, which I'd know from a previous foot fracture that wasn't diagnosed correctly due to a doc checking xrays, but not asking for an MRI. In conclusion, I'm starting to feel this doctor either isn't comfortable with diagnosing (or maybe treating) my injury, or he just doesn't know what he's doing. At any rate, I did get some relief from the first PT session, but plataued after that. I still have a non-stop headace of varying degrees, soreness and stiffness of neck, shoulders and back, especially the areas I noted earlier. I've told the work comp claims nurse and company rep that I've seen too many red flags with this doctor, and I think I need a second opinion. From January 24th till now, I've had nearly no improvement, and I haven't had a decent nights' sleep since the injury. For the record, the company , which is from another state, and gone now that the job is done, and it's insurance company are both cooperating fully to this point and have been very helpful. I chose the doctor by someones advice that I trust. My problem is, I don't think he is competent for this injury. Thanks for any advice or opinions on the injury or the doctor. My apologies for the long dissertation.

3 Replies:

You certainly need to have an MRI or a CAT SCAN as soon as possible for a decent diagnosis of the effects that the impact had on your brain, brain stem, and all vertebrae from your axis thru your lower lumbar and sacrum. This is especially important because impact injuries that are not treated promptly will in many cases lead to degeneration and worsen with time. It might be wise to have a chiropractor who has a good reputation diagnose your injury. Did you have an x-ray of your brain and brain stem after the injury? Was your whole back x-rayed? You need to know what x-rays were taken and definitely need a second and maybe a team of back and spine injury specialists including a neuro surgeon assess and diagnose your injury. Surgery is not always the best solution. Hope this helps.

Thanks, it does help! At this point, any opinions are very welcome. I hadn't even considered a chiropractor, but that sounds like a good idea. The comp insurance person called me back yesterday and said we could get a second opinion, but it would probably end the PT I've got scheduled for the next two weeks. Sounds like it would be a hassle to them, but I just don't trust the doctor I'm seeing now. The degeneration comment is certainly a good point. THanks again!

Oh, and to answer your other questions, I did get 5 or 6 back, neck and an 'open mouth' xray, where they had me face the machine and open my mouth as far as I could. They took some obliques. No Brain xrays as far as I know. The doc seems to want to dwell on the arthritis that he says is developing in my neck vertebrae (so he says, since I didn't see what he was looking at), and the fact that I have a disc that has slipped in my lower back, which he says has been there since birth, but I have found that there are many ways and times of life that this can occur. I am 50, so i've had a lot of time since birth to accumulate slippage, including the impact that caused this injury. Thanks again for your reply and ideas.